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[Pernicious anemia. A study of initial forms of the disease and diagnostic significance of determination of the intrinsic factor antibody and parietal cell antibody].
Ugeskr Laeger. 1992 Dec 21; 154(52):3758-62.UL

Abstract

In a prospective study of thirty five consecutive patients with decreased plasma cobalamine (P-Cbl), twenty-two (63%) were diagnosed as having pernicious anaemia (PA) (no age or sex differences) on basis of the B12-absorption test and/or megaloblastic changes in the bone marrow. In this group ten patients were anaemic (six of whom were characterized as macrocytic), sixteen of nineteen examined had megaloblastic changes in the bone marrow, and all of thirteen examined had achlorhydria with positive correlation to Parietal Cell Antibodies (PCA). Two patients with PA had normal Cbl-absorption and two had malabsorption at the time of diagnosis. Twenty-one patients (95%) had PCA and thirteen (59%) were Intrinsic Factor Antibody (IFAb) positive. Three patients IFAb-seroconverted within a year. Among the remaining thirteen patients (37%), one had PCA but not IFAb and three were IFAb-positive all of whom had normal Cbl-absorption. Of the three patients with IFAb one had also PCA, one IFAb-seroconverted within three months, and one had microcytic anaemia with iron depleted bone marrow due to coecal cancer. Among twenty two healthy adult controls four (18%) had PCA while none had IFAb. This investigation shows that at the debut half of PA patients (55%) do not have anaemia, some have normal Cbl-absorption and some have malabsorption. 95% have PCA and 59% have IFAb. So, IFAb-negative PA is often seen (41%) and seroconversion can take place. Diagnosis is even more reliable, when achlorhydria is present in PCA-positive persons. Healthy PCA-positive persons are probably predisposed to develop PA. Patients with cbl-deficiency, IFAb and/or PCA must be considered as having latent PA even if they have normal haemoglobin and normal Cbl-absorption. These patients should be followed and, in case of anaemia or signs of neuropathia, treated.(

ABSTRACT

TRUNCATED AT 250 WORDS)

Authors+Show Affiliations

Medicinsk endokrinologisk afdeling F. Køebenhavns Amts Sygehus i Herlev.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

dan

PubMed ID

1471305

Citation

Ottesen, M, et al. "[Pernicious Anemia. a Study of Initial Forms of the Disease and Diagnostic Significance of Determination of the Intrinsic Factor Antibody and Parietal Cell Antibody]." Ugeskrift for Laeger, vol. 154, no. 52, 1992, pp. 3758-62.
Ottesen M, Feldt-Rasmussen UF, Andersen J, et al. [Pernicious anemia. A study of initial forms of the disease and diagnostic significance of determination of the intrinsic factor antibody and parietal cell antibody]. Ugeskr Laeger. 1992;154(52):3758-62.
Ottesen, M., Feldt-Rasmussen, U. F., Andersen, J., Hippe, E., & Schouboe, A. (1992). [Pernicious anemia. A study of initial forms of the disease and diagnostic significance of determination of the intrinsic factor antibody and parietal cell antibody]. Ugeskrift for Laeger, 154(52), 3758-62.
Ottesen M, et al. [Pernicious Anemia. a Study of Initial Forms of the Disease and Diagnostic Significance of Determination of the Intrinsic Factor Antibody and Parietal Cell Antibody]. Ugeskr Laeger. 1992 Dec 21;154(52):3758-62. PubMed PMID: 1471305.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Pernicious anemia. A study of initial forms of the disease and diagnostic significance of determination of the intrinsic factor antibody and parietal cell antibody]. AU - Ottesen,M, AU - Feldt-Rasmussen,U F, AU - Andersen,J, AU - Hippe,E, AU - Schouboe,A, PY - 1992/12/21/pubmed PY - 1992/12/21/medline PY - 1992/12/21/entrez SP - 3758 EP - 62 JF - Ugeskrift for laeger JO - Ugeskr Laeger VL - 154 IS - 52 N2 - In a prospective study of thirty five consecutive patients with decreased plasma cobalamine (P-Cbl), twenty-two (63%) were diagnosed as having pernicious anaemia (PA) (no age or sex differences) on basis of the B12-absorption test and/or megaloblastic changes in the bone marrow. In this group ten patients were anaemic (six of whom were characterized as macrocytic), sixteen of nineteen examined had megaloblastic changes in the bone marrow, and all of thirteen examined had achlorhydria with positive correlation to Parietal Cell Antibodies (PCA). Two patients with PA had normal Cbl-absorption and two had malabsorption at the time of diagnosis. Twenty-one patients (95%) had PCA and thirteen (59%) were Intrinsic Factor Antibody (IFAb) positive. Three patients IFAb-seroconverted within a year. Among the remaining thirteen patients (37%), one had PCA but not IFAb and three were IFAb-positive all of whom had normal Cbl-absorption. Of the three patients with IFAb one had also PCA, one IFAb-seroconverted within three months, and one had microcytic anaemia with iron depleted bone marrow due to coecal cancer. Among twenty two healthy adult controls four (18%) had PCA while none had IFAb. This investigation shows that at the debut half of PA patients (55%) do not have anaemia, some have normal Cbl-absorption and some have malabsorption. 95% have PCA and 59% have IFAb. So, IFAb-negative PA is often seen (41%) and seroconversion can take place. Diagnosis is even more reliable, when achlorhydria is present in PCA-positive persons. Healthy PCA-positive persons are probably predisposed to develop PA. Patients with cbl-deficiency, IFAb and/or PCA must be considered as having latent PA even if they have normal haemoglobin and normal Cbl-absorption. These patients should be followed and, in case of anaemia or signs of neuropathia, treated.(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0041-5782 UR - https://www.unboundmedicine.com/medline/citation/1471305/[Pernicious_anemia__A_study_of_initial_forms_of_the_disease_and_diagnostic_significance_of_determination_of_the_intrinsic_factor_antibody_and_parietal_cell_antibody]_ L2 - http://www.diseaseinfosearch.org/result/441 DB - PRIME DP - Unbound Medicine ER -